大柴胡汤加味联合西药治疗肥胖型2型糖尿病的临床疗效及对患者胰岛素抵抗的影响

The Clinical Effect of Flavored Major Bupleurum Decoction Combined with Western Medicine on Type 2 Diabetes Mellitus of Obesity Type and its Influence on Insulin Resistance

目的:观察大柴胡汤加味联合西药治疗肥胖型2型糖尿病(type 2 diabetes mellitus,T2DM)的临床疗效及对患者胰岛素抵抗的影响。方法:选取2018年3月至2019年3月本院治疗的肥胖型T2DM患者104例,依据随机对照原则分为对照组和试验组,每组52例。对照组给予常规西药治疗,试验组在对照组治疗的基础上加用大柴胡汤加味治疗。结果:试验组总改善率为88.46%,对照组总改善率为73.08%,试验组高于对照组,差异有统计学意义(P<0.05);试验组治疗后胃脘胀满、胸肋胀闷、心烦易怒、口干口苦、体型肥胖、大便秘结等中医证候积分均显著低于对照组,差异有统计学意义(P<0.05);试验组患者治疗后空腹血糖、餐后2 h血糖、糖化血红蛋白、体质量指数均显著低于对照组,差异有统计学意义(P<0.05);试验组治疗后胰岛素抵抗指数低于对照组,胰岛素敏感指数、β-细胞功能指数均高于对照组,差异有统计学意义(P<0.05)。结论:大柴胡汤加味联合西药治疗肥胖型T2DM,可明显改善患者血糖控制效果和胰岛功能。

Objective:To observe the clinical effect of Flavored Major Bupleurum Decoction combined with Western medicine on type 2 diabetes mellitus(T2 DM)of obesity type and its influence on insulin resistance.Methods:A total of 104 patients with T2 DM of obesity type treated in our hospital from March 2018 to March 2019 were selected and divided into the control group and the experimental group according to the principle of random control,with 52 cases in each group.The control group was treated with conventional Western medicine,while the experimental group was treated with Flavored Major Bupleurum Decoction on the basis of the treatment in the control group.Results:The total improvement rate was 88.46% in the experimental group and 73.08% in the control group.The difference was statistically significant(P<0.05).After the treatment,the scores of TCM syndromes in the experimental group such as epigastric distention,chest and rib distention,irritablity,dry mouth and bitter mouth,obesity,etc.were significantly lower than those in the control group,and all the differences were statistically significant(P<0.05).The fasting blood glucose,2 hours postprandial blood glucose,glycosylated hemoglobin and body mass index in the experimental group were significantly lower than those in the control group,and all the differences were statistically significant(P<0.05).After the treatment,the insulin resistance index of the experimental group was lower than that of the control group,and the insulin sensitivity index and β-cell function index were higher than those of the control group(P<0.05).Conclusion:In terms of treating T2 DM of obesity type,Flavored Major Bupleurum Decoction combined with Western medicine can significantly improve the effect of blood glucose control and insulin function of the patients.